Abstract：
OBJECTIVE: Is low serum 25-hydroxyvitamin D (25(OH)D) associated with an increased risk of miscarriage in women who presented with threatened miscarriage to the Early Pregnancy Assessment Clinic (EPAC)?
METHODS: This was a secondary retrospective analysis using archived serum samples from a randomized, double-blind, placebo-controlled trial. Stored serum samples from 371 women presenting to the EPAC with threatened miscarriage during the first trimester were assayed for 25(OH)D by liquid chromatography-mass spectrometry.
RESULTS: The overall miscarriage rate was 45/371 (12.1%) in the whole cohort. After grouping vitamin D insufficiency and vitamin D sufficiency together into a \'non-deficient\' group and excluding participants who underwent termination of pregnancy, there was no difference in the miscarriage rate between those who were vitamin D deficient compared with those who were not (25/205, 12.2% versus 20/157, 12.7%, P= 0.877, odds ratio 0.951, 95% CI 0.507-1.784). When analysed according to the number of gestational weeks, the miscarriage rate was significantly higher in the vitamin D non-deficient group than the vitamin D-deficient group in women who presented at 6 gestational weeks or earlier (13/33 [39.4%] versus 10/58 [17.2%], P= 0.019), but there were no statistically significant differences between the two groups presenting at later gestations. There was no difference in the vitamin D level in women who had a miscarriage compared with those who had a live birth (48 [37-57] versus 47 [37-58] nmol/l, P= 0.725 median [25th-75th percentile]).
CONCLUSIONS: A low serum vitamin D concentration was not associated with an increased risk of miscarriage in women with threatened miscarriage presenting to the EPAC.
METHODS: This was a secondary retrospective analysis using archived serum samples from a randomized, double-blind, placebo-controlled trial. Stored serum samples from 371 women presenting to the EPAC with threatened miscarriage during the first trimester were assayed for 25(OH)D by liquid chromatography-mass spectrometry.
RESULTS: The overall miscarriage rate was 45/371 (12.1%) in the whole cohort. After grouping vitamin D insufficiency and vitamin D sufficiency together into a \'non-deficient\' group and excluding participants who underwent termination of pregnancy, there was no difference in the miscarriage rate between those who were vitamin D deficient compared with those who were not (25/205, 12.2% versus 20/157, 12.7%, P= 0.877, odds ratio 0.951, 95% CI 0.507-1.784). When analysed according to the number of gestational weeks, the miscarriage rate was significantly higher in the vitamin D non-deficient group than the vitamin D-deficient group in women who presented at 6 gestational weeks or earlier (13/33 [39.4%] versus 10/58 [17.2%], P= 0.019), but there were no statistically significant differences between the two groups presenting at later gestations. There was no difference in the vitamin D level in women who had a miscarriage compared with those who had a live birth (48 [37-57] versus 47 [37-58] nmol/l, P= 0.725 median [25th-75th percentile]).
CONCLUSIONS: A low serum vitamin D concentration was not associated with an increased risk of miscarriage in women with threatened miscarriage presenting to the EPAC.
摘要：
目的：在早期妊娠评估诊所（EPAC）出现先兆流产的妇女中，血清25-羟基维生素D（25（OH）D）水平低是否与流产风险增加有关？
方法：这是一项二级回顾性分析，使用来自随机，双盲,安慰剂对照试验。通过液相色谱-质谱法测定了在妊娠早期有先兆流产的371名妇女的血清样本中的25（OH）D。
结果：在整个队列中，总体流产率为45/371（12.1%）。在将维生素D不足和维生素D充足性分组为“非缺乏”组并排除终止妊娠的参与者后，与维生素D缺乏者相比，流产率没有差异（25/205，12.2％与20/157，12.7％，P=0.877，比值比0.951，95%CI0.507-1.784）。当根据妊娠周数进行分析时，在妊娠6周或更早出现的妇女中，维生素D非缺乏组的流产率显著高于维生素D缺乏组(13/33[39.4%]对10/58[17.2%],P=0.019),但两组在妊娠后期表现出的差异无统计学意义.与活产妇女相比，流产妇女的维生素D水平没有差异（48[37-57]与47[37-58]nmol/l，P=0.725中位数[第25-75百分位数])。
结论：低血清维生素D浓度与出现EPAC的先兆流产的女性流产风险增加无关。
方法：这是一项二级回顾性分析，使用来自随机，双盲,安慰剂对照试验。通过液相色谱-质谱法测定了在妊娠早期有先兆流产的371名妇女的血清样本中的25（OH）D。
结果：在整个队列中，总体流产率为45/371（12.1%）。在将维生素D不足和维生素D充足性分组为“非缺乏”组并排除终止妊娠的参与者后，与维生素D缺乏者相比，流产率没有差异（25/205，12.2％与20/157，12.7％，P=0.877，比值比0.951，95%CI0.507-1.784）。当根据妊娠周数进行分析时，在妊娠6周或更早出现的妇女中，维生素D非缺乏组的流产率显著高于维生素D缺乏组(13/33[39.4%]对10/58[17.2%],P=0.019),但两组在妊娠后期表现出的差异无统计学意义.与活产妇女相比，流产妇女的维生素D水平没有差异（48[37-57]与47[37-58]nmol/l，P=0.725中位数[第25-75百分位数])。
结论：低血清维生素D浓度与出现EPAC的先兆流产的女性流产风险增加无关。
